Abstract The broad, long-term objective of the parent grant (U01 DA040219) is to reduce prevalence of prescription stimulant medication (PSM) misuse among college students, through development and testing of efficacious and cost-effective personalized feedback interventions (PFI). The current supplement proposes to advance efforts to combat the opioid crisis in the United States, particularly among college students, through documenting perceived norms of non-medical use of prescription opioid pain relievers (NPO) and the relationship to actual NPO, assess the relationship between perceived risks, consequences, and use of NPO, explore the impact of media attention on perceived norms and risks, document comorbid substance use with NPO, and develop and pilot test a brief NPO intervention. Both this supplement and the parent grant involve collaboration of 3 research teams with unique strengths to address this problem. Dr. Arria?s College Life Study is one of the largest and most comprehensive studies of PSM in college students. The University of Washington (Geisner, Kilmer) are pioneers in developing and adapting screening and brief Personalized Feedback Interventions (PFI) for a range of addictive behaviors. The University at Albany (Cimini) is nationally recognized for implementing cutting edge interventions into ?real-world? campus health and counseling settings. This team has been working together to develop and test a brief PFI for non-medical use of one class of prescription medications ? stimulants. Thus, we have gained experience that will apply readily to development of similar content for another class of prescription medications: NPO. Study 3 of the parent grant will is a RCT of PFI for stimulants, and thus will allow for an ideal setting to pilot the new NPO materials. The supplement also addresses several gaps in the literature on NPO, including assessment of risk factors such as normative perceptions and risk perception, building on the parent aims. Aims of this supplemental research directly relate to Aims of the parent grant and include: 1) Document perceived norms for NPO, and the extent to which norms are misperceived relative to actual use. Further, evaluate the relationship between misperceived norms and actual NPO both concurrently and prospectively among individuals with Non-medical use of Prescription Stimulants (NPS). 2) Assess perceived risks and actual experienced consequences of NPO, and the extent to which perceived risks vary by past NPO and predict future NPO and consequences. 3) Evaluate the extent to which self-reported exposure to media descriptions (e.g., descriptions of a ?crisis? and/or ?epidemic?), access to opioids, and costs are related to perceived descriptive norms and perceived risks of NPO. 4) Document comorbidity between NPO, NPS and other substance use, particularly cannabis and alcohol. Understand the extent to which relationships between perceived norms, perceived risks, and NPO use are moderated by other substance use. 5) Develop and pilot-test an NPO brief intervention module to address this comorbidity among college students with NPS.